MEDICARE: ALLENDALE COUNTY RESCUE SQUAD INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3416L0300X	Land Ambulance

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083693832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLENDALE COUNTY RESCUE SQUAD INC

Provider Business Mailing Address
First Line	:	PO BOX 1245
Second Line	:
City	:	WALTERBORO
State	:	SC
Zip	:	29488
Country	:	US
Telephone Number	:	843-549-3444
Fax Number	:	843-549-3474

Provider Business Practice Location Address
First Line	:	606 HICKORY ST
Second Line	:
City	:	ALLENDALE
State	:	SC
Zip	:	29810
Country	:	US
Telephone Number	:	803-584-4900
Fax Number	:	803-584-0400

Authorized Official
Title or Position	:	DIRECTOR CAPTAIN
Name	:	MR. JOHN MARSHALL LAWSON III
Credential	:	PARAMEDIC DIRECTOR
Telephone Number	:	803-584-4900

Provider Enumeration Date	:	01/11/2006
Last Update Date	:	11/30/2012

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Directions to “ALLENDALE COUNTY RESCUE SQUAD INC ” Practice Location

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